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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT01420367
Registration number
NCT01420367
Ethics application status
Date submitted
18/08/2011
Date registered
19/08/2011
Date last updated
19/08/2011
Titles & IDs
Public title
Are Post-operative Antibiotics Indicated in Simple Appendicitis?
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Scientific title
Are Post-operative Antibiotics Indicated in Simple Appendicitis? A Prospective Randomized Trial
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Secondary ID [1]
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U1111-1123-7877
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Appendicitis
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Condition category
Condition code
Surgery
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Other surgery
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - metronidazole and cephalzolin
Experimental: Single dose of antibiotics - This group will receive one dose of IV metronidazole (12.5mg/kg up to 500mg) and cefazolin (25mg/kg up to 1g) in the pre-operative period and two post-operative IV 'doses' of normal saline 8 and 16 hours after the pre-operative dose, which will act as a placebo and facilitate blinding.
Active comparator: Three doses of antibiotics - This group will receive one pre-operative dose of IV metronidazole (12.5mg/kg up to 500mg) and cefazolin (25mg/kg up to 1g) and two post-operative doses of IV metronidazole (12.5mg/kg up to 500mg) and cefazolin (25mg/kg up to 1g) 8 and 16 hours after the pre-operative dose.
Treatment: Drugs: metronidazole and cephalzolin
IV doses of metronidazole (12.5mg/kg up to 500mg) and cefazolin (25mg/kg up to 1g). One dose for study arm, two for comparative arm.
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Presence of post-operative infection in the six weeks following appendectomy
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Assessment method [1]
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Defined by wound infection, fever (\>38.5) or evidence of sepsis.
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Timepoint [1]
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6 weeks
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Primary outcome [2]
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Requirement of further antibiotic therapy in the six weeks following appendectomy
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Assessment method [2]
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Administration of antibiotics either by hospital or general practitioner in the 6 week post-operative period.
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Timepoint [2]
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6 weeks
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Secondary outcome [1]
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Time to discharge taken from the time of operation to the time the child first satisfied the discharge criteria
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Assessment method [1]
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Discharge criteria:
Pain adequately controlled with oral analgesia Tolerating full diet Afebrile
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Timepoint [1]
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1 week
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Secondary outcome [2]
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Re-admission in the six weeks following appendectomy
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Assessment method [2]
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Re-admission to the treating hospital or any other hospital in the 6 weeks post-operative period.
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Timepoint [2]
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6 weeks
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Eligibility
Key inclusion criteria
* All patients who have their appendix removed and are found on operation to have 'simple appendicitis' as defined in the Cochrane review[7]. That is an appendix that is non-inflamed, acutely inflamed, phlegmonous, suppurative or mildly inflamed.
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Minimum age
4
Years
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Maximum age
17
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
* Patients who on operation are found to have 'complicated appendicitis' defined as an appendix that is gangrenous or perforated.
* Patients who pre-operatively appear to be acutely septic or for another reason require extended antibiotic therapy.
* Patients who, at operation, are found to have other pathology e.g. Meckel's Diverticulum, Intussusception; requiring surgical or medical intervention.
* Any patient whose guardian does not wish for them to participate in the study.
* Patients who have additional co-morbidities, including diabetes, immuno-suppression, cardiac, renal or liver failure.
* If the child continues to show sign of sepsis, in terms of fever, tachycardia, he/she will be discontinued from the study and be given additional doses of antibiotics, as clinically indicated.
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Study design
Purpose of the study
Prevention
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
The people assessing the outcomes
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Intervention assignment
Parallel
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Other design features
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Phase
NA
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
UNKNOWN
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
1/11/2011
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
1/12/2013
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Actual
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Sample size
Target
300
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
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Monash Medical Centre - Clayton
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Recruitment postcode(s) [1]
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3168 - Clayton
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Funding & Sponsors
Primary sponsor type
Other
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Name
Monash University
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Address
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Country
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Other collaborator category [1]
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Other
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Name [1]
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Monash Medical Centre
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Address [1]
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Country [1]
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Ethics approval
Ethics application status
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Summary
Brief summary
Hypothesis: A single dose of prophylactic antibiotics is as effective as a three dose regime in preventing post-operative complications in paediatric patients with simple appendicitis. This project will compare patients 16 years and under with simple appendicitis (appendicitis that is not perforated or gangrenous). Patients will be randomly divided into two groups; * Group one will receive a single pre-operative dose of antibiotics (metronidazole 12.5mg/kg up to 500mg and cefazolin 25mg/kg up to 1g) and two 'doses' of normal saline (placebo) eight and sixteen hours after the initial dose, respectively. * Group two will receive one pre-operative dose of antibiotics (metronidazole 12.5mg/kg up to 500mg and cefazolin 25mg/kg up to 1g) and two post-operative doses, eight and sixteen hours after the first dose, respectively. Group allocation will be concealed from the patient and their guardian, the treating surgical team and outcome assessors (triple blinded). A process to rapidly reveal group allocation if required will be in place. The aim of the study is to determine if a single dose of antibiotics is as effective as three doses in preventing post-operative infection. This will be assessed by comparing: * Duration of hospital stay from operation until discharge, based on a standardised discharge criteria. * Development of wound infection or requirement of antibiotics in the six weeks post-operation * Need for re-admission. Information will be collected prospectively from each patient's hospital notes and from a follow-up phone call six weeks after the operation.
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Trial website
https://clinicaltrials.gov/study/NCT01420367
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Nicole Mennie, MBBS
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Address
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Monash University
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Nicole Mennie, MBBS
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Address
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Country
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Phone
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Fax
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Email
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[email protected]
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Contact person for scientific queries
No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT01420367
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